Adolescent Violence—Strategies,Outcomes and Dilemmas in Working with Young People and their Families

MATTERS is a program of Berry Street, and has been in existence since 1990. The service is funded to address parent/adolescent conflict and the service delivery model has developed over time in a direction which incorporates family therapy and conflict resolution techniques. Many families come to the service seeking assistance for problems regarding violence, and increasingly around a young person's violence to parents and other family members. In some instances, violence has been present over a long period and has become normalised within the family's experience. When working with families who present with problems of adolescent violence, the service aims to find a pathway for the young person/family to confront violent behaviour and move to a different position about the meaning of violence in their lives. This paper describes the team's approach to working with adolescent violence, utilising ideas from narrative family therapy and psychodynamic theory, and incorporating issues of power in society, culture and gender. Outcomes, dilemmas and future directions are also discussed.     

Responding to Adolescent Violence in the Home – A Community Mental Health Approach

Family violence perpetrated by adults is increasingly understood as a health issue, and we argue that this pertains even more strongly to violence by adolescents. The co-dependence of the parent–child bond, lack of maturity in the adolescent, and often related issues of disability or mental illness make these young people both complex and also vulnerable. This research paper reviews the current literature relating to adolescent violence in the home, identifies known best practice, and evaluates the importance of taking a family-focused, therapeutic approach to adolescent family violence, in place of a punitive one. It describes the use of a co-design workshop to unpack gaps in service provision and develop a potential family focused model of care to address the needs both of young people who use violence, and their families. The findings indicate that an inclusive family approach is a key element in addressing adolescent violence in the home across a spectrum of behaviours and mental health care needs. The use of a coordinated, family-inclusive response through mental health care services is recommended to address the complexity of this issue, as well as to provide support both to adolescents and to their families and carers.     

A Pilot Study to Explore the Influence of the ‘Safety First Assessment Intervention’ on the Family Environment

The family environment is considered an important influence on a young person's well‐being. The ‘Safety First Assessment Intervention’ is a model of care that considers and incorporates the importance of family environment when assessing and managing distressed young people. This pilot study explores the influence of the ‘Safety First Assessment Intervention’ on the family environment of young people referred to Child and Adolescent Mental Health Services. A pre‐ and post‐design was used, with families completing the Family Survey before and after their assessment/intervention. The Family Survey was correlated with a validated measure of family function, the APGAR, and pre‐intervention. Significant changes in multiple dimensions of family environment, including reduced level of distress for the adult, increased level of distress for the young person, improved sense of how the family felt the adult was managing currently, and improved confidence in family communication were found. There was no significant change in how the adult understood their role in helping the young person manage their distress. A thematic analysis showed trends in the current concerns for young people and adults as well as the difficulty young people in distress have in identifying their strengths. This pilot study demonstrates that the ‘Safety First Assessment Intervention’ can influence the family environment in a positive way and highlights the importance of using a family‐based approach for distressed young people.     

A Mixed Methods Exploration of Single Session Family Therapy in a Child and Adolescent Mental Health Service in Tasmania,Australia

Single session therapy (SST) is grounded in the belief that clients and families can effect change after one therapeutic encounter, using their own resources, with brief support and assistance from therapists. SST has been found to be an effective intervention for children, young people, and their families presenting with a wide range of difficulties. Research in child and adolescent mental health has shown that over 50% of families find one SST encounter is enough with no need for further specialist input. This study aims to explore family member experiences of SST (undertaken as single session family therapy and termed hereafter SSFT) as an initial intervention in a regional child and adolescent mental health service (CAMHS), specifically in terms of worry, confidence, and satisfaction outcomes. An exploratory, mixed methods convergent design was utilised using a combination of open questions and Thurstone scales. All eligible family members were invited to complete questionnaires before and after the SSFT, asking about level of worry, confidence, and overall satisfaction with SSFT. Quantitative and qualitative findings indicated most family members had a positive experience of SSFT, although differences were found between young people, parents, and siblings. Overall, family members’ level of worry decreased, while only parental confidence in managing the presenting issue(s) increased. Over half of the families did not require further contact with CAMHS following the SSFT. Our findings support previous research that SSFT is an effective, family-inclusive, and well received intervention for a variety of mental health issues facing children and young people. SSFT could be considered a beneficial and well received first response for the majority of CAMHS clients, which prioritises a family-inclusive approach. Future research could focus on attaining a more in-depth understanding of individual family member experiences with a view to improving SST delivery.     

The Role of Mobile Phones in Family Communication

Whilst there is a wealth of research into family communication and family relationships, there is little information about whether (and if so how) mobile phones have impacted on these processes. The authors’ study involved individual semi‐structured interviews with 60 families, including parents/carers and young people aged 11–17, to investigate this further. The interviews explored how mobile phones are used in family communication; participants’ views about the benefits and disadvantages of mobile phone use; and issues around safety, surveillance and privacy. The findings show that young people and parents see mobiles as a key way for families to keep in touch, and to monitor and ensure young people’s safety. However, some participants felt there was a downside to this, in relation to some young people either withdrawing into their own social worlds, or having a false feeling of security as a result of having a mobile. Gender differences in views and usage were also found. The paper concludes with some general comments about the role of mobile phones in family life.     

Adolescents from Stepfamilies,Single-Parent Families and (In) Stable Intact Families in The Netherlands

This aiticle 'examines the effects on intimate relation- ships, relational attitudes, and well-being of growing up in: stepfami- lies after divorce, single-parent families, instable intact families, and stable intact families. Data are used from the national panel study USAD (Utrecht Study of Adolescence Development), a study of de- velopments as they occur in the life course of young people during h e 1990s. Results are presented from 2,064 respondents between 15 and 25 years of age, about their well-being and their development in inti- mate relationships and their views on (marriage) relationships. On a number of topics their parents are interviewed as well. From the analysis, it is clear that young people who lived in single- parent families and in stepfamilies significantly differ from young people who lived in stable intact families. Young people from single- parent families are more likely to start their relational career sooner and reported more problems with intimate relations than youngsters from stable intact families. Youngsters from stepfamilies have more modem views on relations than people from intact families. Adolescents from instable intact families have moderate scores. Most of these effects re- main when the results are adjustdfor differences in social class, family income and the parental views on family life.     

Safety First: A Model of Care for Working Systemically With High Risk Young People and Their Families in an Acute CAMHS Service

The following article outlines the Safety First Model for working with high‐risk young people in crisis. This hierarchical model prioritises emotional and physical safety by using multi‐systemic and family‐based interventions. A typical case example is used to illustrate the model and the structures and strategies employed at each level. The intervention model empowers families, facilitates their connections with other providers, and minimises the need for hospital admissions. The model also promotes collaborative and systemic practice in a child and adolescent mental health service.     

Collaborative Family Work in Youth Justice

ABSTRACT

A number of studies have found that working with family groups can be successful in improving outcomes for young people and their families. This article reports on a study in New South Wales in which juvenile justice staff offered collaborative family work interventions to young people as part of the routine offerings of a juvenile justice service. The primary objective of this study was to examine the extent to which young people who completed the family work had lower recidivism rates compared to three control groups. The methods included a comparison of recidivism rates between young people who completed the intervention, those who failed to complete, those who declined, and a matched sample of young people who were not offered the intervention. The results of the study indicated that many young people and their families were agreeable to be involved in the intervention and the completion rates were high, particularly if the work was undertaken in the family home. The young people who completed the intervention also had lower recidivism rates than young people in each of the control groups.

IMPLICATIONS

• Collaborative family work can be offered successfully by juvenile justice services to young offenders and their families.

• Collaborative family work can reduce recidivism rates for those who complete the intervention.

• It is preferable to conduct the work in the family home where completion rates are likely to be higher.

     

Family violence laws: Traditional narratives and the (in)visibility of lesbian relationships and lesbian-parented families

Abstract

Feminist advocacy and activism over the last 40 years broke historic ground in shining a light on “domestic” or “family” violence, traditionally conceptualized as male violence against female intimate partners and their children. This has resulted in a large body of research, particularly in the United States, United Kingdom, Australia, and similar jurisdictions, around the gendered nature of family violence and violence within heterosexual relationships and heterosexual-parented families. As a consequence, the predominant narrative—in political, policy, and advocacy settings—is largely heteronormative. Less research has focused on family violence in non-heterosexual relationships. The data that do exist have employed different methodological approaches and there are limitations on the extent to which they can be compared to the data on violence within heterosexual relationships. However, the existing research does demonstrate that family violence within lesbian, gay, bisexual, transgender, and intersex (LGBTI) communities is a significant issue. Even so, the current narrative does not acknowledge this, and predominantly reflects heterosexual norms of intimate relationships and family structures in society. LGBTI relationships are described as “invisible” in policy and practice responses to family violence, due to the failure to acknowledge violence in such communities. This article explores these claims in relation to lesbian relationships in the context of Australian legislative responses to family violence. It considers the extent to which family violence laws in two Australian jurisdictions recognize and frame lesbian identity in intimate relationships and lesbian-parented families. This is considered in light of the emerging conceptualization of family violence in lesbian relationships and lesbian-parented families, as evidenced by the wider scholarly literature on the nature and dynamics of such violence.     

Every Dot has a Meaning

Family therapy in Australia has recently begun a conversation with the indigenous people of this country. Part of this dialogue has involved family therapists listening to the stories of violence and oppression perpetrated against the Aboriginal people under the name of “protection”. This article is part of the ongoing exchange between family therapists and Kooris documenting the suffering of “the stolen generation”. Here two young people removed from their families as small children and raised in the same Aboriginal children's home, speak personally through their art, of an agonising search for family and cultural identity.     

Homeless Careers: A Framework for Intervention

Abstract

The present paper identifies three ‘homeless careers’ abstracted from the diversity and complexity of individual cases and pathways. These are the ‘youth career’, the ‘housing crisis career’ and the ‘family breakdown career’. The paper discusses the usefulness of the career typology for framing interventions. A core argument is that early intervention involves different forms of practice in each pathway. For young people, early intervention has to occur when they are at the ‘in-and-out’ stage, before they have made a permanent break from family. For adults experiencing housing crisis, early intervention is about providing assistance to people before they lose their accommodation. The family breakdown career commonly involves domestic violence, so although early intervention may involve family reconciliation, in many cases it involves supporting victims of domestic violence to move to alternative, secure accommodation.     

Supporting Traditional African Mediators Project (STAMP) for Family Violence

Supporting Traditional African Mediators Project (STAMP) is a program that has been working with African/Australian community leaders to prevent family violence. This program has been carefully developed through building long‐term relationships, transparency and openness with an emphasis on navigating the intersection of cultures in order to enhance understanding and collaboration around family violence prevention. The training program has successfully engaged both men and women and enhanced participation, cross cultural learning and positive outcomes by creating an open and safe environment. The paper highlights the knowledge gained by participants and project workers and explores the challenges experienced by people who emigrate from other countries when responding to family conflict in an Australian context. It introduces the formation of a support group Marula that has added value and support to Traditional African Mediators in their work to address family violence within their communities.     

The Continuation of Intimate Partner Violence From Adolescence to Young Adulthood

Little attention has been paid to whether violence in adolescent romantic relationships is associated with relationship violence later in young adulthood. This study examined the continuation of intimate partner violence (IPV) from adolescence to young adulthood. Using data from the National Longitudinal Study of Adolescent Health, results from negative binomial models and propensity score models showed that being victimized by relationship partners in adolescence was significantly associated with both perpetration and victimization in romantic relationships in young adulthood. Women reported higher levels of perpetration and lower levels of victimization than men did. Those who were living together (married or cohabiting) reported higher levels of victimization and perpetration than those who were dating. Further, such associations existed beyond the effects of parent–child violence and general aggression tendencies, suggesting the continuation of relationship‐specific violence. Finally, these patterns persisted after controlling for participants' age, race and ethnicity, parental education, and family structure.     

Connecting and Strengthening Young Aboriginal Men: A Family Wellbeing Pilot Study

A significant proportion of young people in Australia are currently not being engaged in school and other social systems. This article presents the results of a mixed-methods study of a pilot Family Wellbeing intervention designed to enhance the social and emotional wellbeing (SEWB) of young Aboriginal men and improve engagement in education, employment, and other social participation. A questionnaire incorporating the Kessler Psychological Distress Scale and respondent self-assessment SEWB questions was administered to program participants pre and post intervention (N = 30) and qualitative data were collected from program organisers (N = 6). The results suggest that the Family Wellbeing intervention has the capacity to make a marked contribution to the SEWB of young Aboriginal men; participants experienced strong improvement in capacity to manage relationships, engagement in education and employment, and mental and physical health. The factors that enabled the program to be adapted to the target group and setting are documented.     

Young People who have Sexually Abused: What do they (and their parents) want from Professionals?

This article presents the findings of a small scale qualitative study of user perspectives in the adolescent sexual aggression field. Twenty four service users who had received intervention from nine different specialist providers completed a structured questionnaire about their experiences of professional involvement. Both young people who had sexually abused and parents identified the kinds of professional intervention which they found useful, as well as practices that they experienced as unhelpful. Young people and their families alike were found to value supportive interventions which gave them an opportunity to gain insight into the nature of sexual abuse as well to address their own feelings about their problems.     

A multi-site study of the ACT Raising Safe Kids program: Predictors of outcomes and attrition

The present study examined the factors related to attrition and treatment outcomes in the ACT-Raising Safe Kids (ACT-RSK) program. ACT-RSK is a family violence and child abuse prevention program for parents and caregivers of young children. Sixty parents or caregivers of children aged 9 years or younger completed the ACT-RSK group program and the research measures. The study took place at 7 community-based sites in the midwestern United States. Program completers were significantly older than noncompleters, suggesting that parent age relates to attrition from this program. Pre/post comparisons indicated increased nurturing behavior, decreased harsh parenting, and decreased negative discipline, as well as decreased child behavior problems following completion of the ACT-RSK program. Parent age predicted children's outcomes, indicating better results for the children of older parents/caregivers. In addition, pre-test harsh parenting scores predicted children's outcomes, suggesting that families with relatively higher initial levels of parental psychological aggression and corporal punishment had more robust child outcomes following completion of the program.     

FAMILY STRUCTURE, CLOSENESS TO RESIDENTIAL AND NONRESIDENTIAL PARENTS, AND PSYCHOLOGICAL DISTRESS IN EARLY AND MIDDLE ADOLESCENCE

American adolescents currently live in a variety of different family structures, with the vast majority of adolescents living in intact, blended, divorced, and never-married families. Previous research shows that family structure correlates both with the quality of parent–adolescent relationships and adolescent psychological distress. The quality of parent–adolescent relationships also correlates with adolescent distress. This research hypothesizes that the observed differences in adolescent distress across family structure might result from differences in the quality of parent–adolescent relationships across family structure. Analyses, using data on 1,443 youth in early and middle adolescence from the National Longitudinal Survey of Youth (NLSY), indicate that when the variations in both the quality of parent–adolescent relationships and background characteristics across family structure are controlled, the association between family structure and adolescent psychological distress is significantly reduced. Further analyses revealed that the quality of residential parent–adolescent relationships explained the most variation in adolescent psychological distress. The quality of relationships with nonresidential fathers only had a significant association with adolescent psychological distress for adolescents in blended families.     

Confronting adolescent bias and intolerance through cross-cultural immersion: an American-Croatian collaboration.

This article describes a partnership to develop youth leaders and positive interventions to reverse the cycles of violence and bigotry that come when young people experience the pain and trauma of growing up in a war zone. In Croatia, Project REACH (Recreational and Educational Activities for Children's Health) serves youth who have lost their families--and their innocence--in the senseless war and "ethnic cleansing" of the former Yugoslavia. Its partner, The Children's Village (CV), provides residential treatment services for youth who have lost their families as a result of chronic abuse or neglect and who have been exposed to high levels of family and community violence in one of the most beleaguered urban areas in the United States. The partnership exposed young people from these two supposedly different parts of the world to experiences that would enable them to examine their lives, their biases, and their assumptions about the world. It was hoped that participating youth would come to see their own potential to be leaders in breaking a cycle of violence, promoting tolerance and understanding, and creating a positive effect on the world around them.     

Acceptability of an Aboriginal Wellbeing Intervention for Supporters of People Using Methamphetamines

Families and workers often suffer significant stress while supporting people who are experiencing problems related to methamphetamine use yet there is little evidence on how best to help. Small pilot studies can provide valuable information about potential ways to intervene. This paper presents a pilot study of an Aboriginal family wellbeing intervention with workers in an Aboriginal health service. The pilot indicated that participation in the intervention improved the psychosocial empowerment and wellbeing of workers, that these workers perceived the program as relevant to families, and that this was an intervention they felt they could deliver to clients themselves.

IMPLICATIONS

• An Aboriginal family wellbeing intervention was piloted and found to improve the empowerment and wellbeing of workers. Participants regarded it as highly relevant for families supporting people using methamphetamines and other drugs.

• This research has added to our knowledge about how to assist those supporting Aboriginal people using methamphetamines and other drugs.

     

Engaging with Parents in Child and Adolescent Mental Health Services

This paper asks the question: How can child and adolescent mental health clinicians constructively engage parents as a resource in the young person's treatment? It draws from qualitative research data that explore parents' experience of their involvement in their adolescent's mental health treatment program. The paper especially focuses on challenges for clinicians in engaging with parents as part of the treatment program for young people. Clinicians' input about their perceptions of interacting with parents is utilised alongside parents' experiences of their involvement in clinical processes. The clinician data revealed key challenges were managing their reactions to parent defensiveness; broadening the focus from just alleviating symptoms in the young person; not taking sides with the young person; and resisting becoming an expert instructor. The paper discusses Murray Bowen's original family research about engaging parents in treatment with the symptom bearer and addresses how clinicians can build a positive alliance with parents that avoids blame while constructively opening exploration of the family relationship process as part of a collaborative approach.